Department of Surgery, National Hospital of the Faroe Islands, J.C. Svabosgøta 41-49, 100 Torshavn, Faroe Islands.
Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg, Denmark.
Nutrients. 2022 Jun 23;14(13):2599. doi: 10.3390/nu14132599.
The presence of malnutrition is increasingly becoming a postdischarge problem in surgical patients. We aimed to investigate whether oral nutritional supplements combined with resistance training could minimize skeletal muscle atrophy in surgical patients after discharge. This randomized controlled study was conducted at the Department of Surgery, National Hospital of Faroe Islands from 2018 to 2020. A total of 45 patients aged 37−74 years participated and were allocated to one of three groups: diet (DI; n = 13), exercise and diet (EX + DI; n = 16), or control (CON; n = 16). The intervention period lasted 8 weeks. The intervention groups received individual dietary counselling and a protein-rich oral nutritional supplement twice a day containing 22 g of protein/day. Patients in the EX + DI group were assigned to resistance training sessions. Patients in the CON group received standard care. The primary outcome was change in lean body mass (LBM). Secondary outcomes were change in body weight, handgrip strength, quality of life, surgery-related side effects, energy and protein intake, length of stay and one-year mortality. To estimate within-group changes, linear mixed models including group−time interactions as fixed effects and patients as random effects were fitted. Within-group change in LBM was 233, 813 and 78 g in the DI, EX + DI and CON groups, respectively, with no significant between-group difference (p > 0.05). Pain score declined more (p = 0.04) in the EX + DI group compared with the CON group. Body weight, handgrip strength, quality of life and surgery-related side effects did not differ between groups. At the end of study, mean cumulative weight change in the DI and EX + DI groups was 0.4% and 1.6%, respectively, whereas the CON group experienced a weight loss of −0.6%. No significant difference in primary outcome between groups was noted. However, our results indicate some benefits from exercise and nutrition for malnourished surgical patients.
营养不良在外科患者中越来越成为出院后的问题。我们旨在研究口服营养补充剂联合抗阻训练是否可以最小化出院后外科患者的骨骼肌萎缩。这项随机对照研究于 2018 年至 2020 年在法罗群岛国家医院外科进行。共有 45 名年龄在 37-74 岁的患者参与，并分为三组：饮食组（DI；n=13）、运动和饮食组（EX+DI；n=16）或对照组（CON；n=16）。干预期持续 8 周。干预组接受个体饮食咨询和每天两次富含蛋白质的口服营养补充剂，每天含 22 克蛋白质。EX+DI 组的患者接受抗阻训练。CON 组的患者接受标准护理。主要结局是瘦体重（LBM）的变化。次要结局是体重、握力、生活质量、手术相关副作用、能量和蛋白质摄入、住院时间和一年死亡率的变化。为了估计组内变化，使用包括组-时间交互作用作为固定效应和患者作为随机效应的线性混合模型进行拟合。DI、EX+DI 和 CON 组的 LBM 分别增加了 233、813 和 78g，组间差异无统计学意义（p>0.05）。与 CON 组相比，EX+DI 组的疼痛评分下降更多（p=0.04）。体重、握力、生活质量和手术相关副作用在各组之间没有差异。研究结束时，DI 和 EX+DI 组的平均累积体重变化分别为 0.4%和 1.6%，而 CON 组的体重减轻了-0.6%。组间主要结局无显著差异。然而，我们的结果表明，运动和营养对营养不良的外科患者有一些益处。
